The Psychological Impact of COVID-19 Lockdown on Children and Adolescents in Tunisia: A Cross-Sectional Study

During the COVID-19 pandemic, Tunisia implemented a national lockdown between March and May 2020. This disrupted daily life and limited access to essential services. The restrictions significantly reduced social interactions and outdoor activities for children and adolescents, raising concerns about the psychological impact on this population.

To assess the psychological impact of the COVID-19 lockdown on children and adolescents in Tunisia.

A cross-sectional study using a telephone survey was conducted among 514 Tunisian households in August 2020. We included parents of children aged five to 15 years. The collected data included sociodemographic characteristics, general information, and details on the establishment of routines and adaptive containment measures. A 26-item questionnaire was developed to assess anxiety and emotional and behavioral symptoms. Data were analyzed using descriptive statistics and chi-square tests.

Parents reported depressive symptoms, anxiety symptoms and behavioral manifestations in 38.7%, 69.8% and 61.9% of their children, respectively. Among children, female sex was associated with significantly greater levels of depressive symptoms, sleep disturbances, and eating disturbances (p=0.002, p=0.034 and p=0.011, respectively). Children who had somatic chronic illnesses or whose parents had such conditions reported significantly greater levels of somatic complaints (p=0.037). Those whose fathers continued to work during the lockdown had a more positive attitude toward the COVID-19 pandemic (p=0.027). Children with anxiety symptoms had more positive attitudes towards the COVID-19 pandemic (p=0.002); however, those with depressive symptoms did not (p=0.19).

The COVID-19 lockdown had a substantial psycho-logical impact on children and adolescents in Tunisia, as indicated by high rates of anxiety, depression, and behavioural disturbances. These findings may contribute to the formulation of evidence-based recommendations aimed at safeguarding the mental health of children and adolescents in future pandemic scenarios, thereby minimizing adverse psychological outcomes.